1. An age of 65 years or older and receiving health within a healthcare organization (by receiving outpatient or home care, or living in a care or nursing home);
2. Presence of clinically relevant depressive symptoms (score of 2 or higher on the GDS-8).

- Exclusion criteria

1. Severe cognitive impairment, measured by a score of 18 or lower on the Mini Mental State Examination (MMSE, Folstein et al 1975);
2. The diagnosis of major depressive episode (based on the MINI, 8 or 9 of the 9 DSM-IV symptoms of depression);
3. Having started with medication for depressive symptoms within the past 3 months;
4. Poor command of the Dutch language.

- mec approval received

yes

- multicenter trial

yes

- randomised

yes

- masking/blinding

None

- control

Active

- group

Parallel

- Type

2 or more arms, randomized

- Studytype

intervention

- planned startdate

17-jun-2013

- planned closingdate

30-sep-2013

- Target number of participants

135

- Interventions

Intervention Dear memories: An individual life-review intervention which trains participants to retrieve specific, positive memories. The intervention consists of five structured conversations of 45 minutes each, in which trained volunteers ask questions about memories of once-only, positive events. The themes of the five sessions are: introduction and familiarization, childhood, youth, adulthood and life in general.

Active control condition: Informal contacts with a volunteer, in which the volunteer and the older adult decide together an activity to do.

- Primary outcome

The primary outcome is depressive symptoms, which will be measured at study entry, post-intervention and follow up. Depressive symptoms will be measured by means of the 8-item Dutch version of the Geriatric Depression Scale (GDS-8; Jongenelis et al., 2007).

- Secondary outcome

Secondary outcomes, which will be measured at study entry, post-intervention and follow up, are anxiety symptoms, positive mental health, mastery, loneliness, and specific positive memories. Anxiety symptoms will be measured with the Anxiety subscale of the Hospital Anxiety and Depression Scale (HADS-A, Zigmond & Snaith, 1983). Positive mental health will be measured using the Mental Health Continuum – Short Form (MHC-SF; Lamers et al., 2011). Loneliness will be assessed with a scale developed by de Jong-Gierveld and Kamphuis (1985). Mastery will be assessed with the Pearlin Mastery Scale (Pearlin & Schooler, 1978). Specific, positive memories will be measured using the Autobiographical Memory Test (AMT; Williams & Broadbent, 1986). Other secondary measures, which will be measured at study entry and follow up, are functional limitations, general cognitive functioning and depressive episode. Number of functional limitations were indicated by the Groningen Activity Restrictions Scale (GARS; Kempen et al., 1990). General cognitive functioning will be assessed by means of the 30-item Mini-Mental State Examination (MMSE; Folstein et al., 1975). The presence of major depressive disorder according to DSM-IV criteria will be assessed with The Mini-International Neuropsychiatric Interview (M.I.N.I; Sheehan et al., 1998).

- Timepoints

Participants have to complete measures at study entry (t0), post-intervention (t1; directly after the intervention, 2 months after study entry), and follow up (t2; 6 months after the end of the intervention).

Depression is highly prevalent in frail older adults. The main risk factor for developing a depression is the presence of mild to moderate depressive symptoms. Prevention reduces the number of new cases. Life-review can be considered as an acceptable method for this target group. Central in life-review is an active (re) evaluation of one's own life. Recently, a new individual life-review intervention is developed specifically for frail older adults: 'Dear memories'. The intervention trains the retrieval of specific positive memories. There is a protocol developed for facilitators of the intervention and the intervention has been evaluated in a pilot study by the University of Amsterdam (Vrije Universiteit). Now a randomized, controlled trial is proposed on its effects on depression, anxiety, positive mental health, loneliness and mastery. The intervention will be conducted by trained volunteers.